GREATER DALLAS MORTGAGE

Primary Borrower:    



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               Bus:  



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Co-Borrower Information











Co-Borrower:         



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Objective:







Primary Residence purchase  



Refinance  



Investment purchase  







If purchase loan, has property been located?







Yes  



No  







Sales Price:  

Current Employer:      



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If Self Employed:    



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Previous Employer:     



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Commission:          

Current Employer:      



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If Self Employed:    



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Source of funds to close 



(Down Payment, Closing Costs and Prepaids):  



Approximate total of all savings:            

Revolving (Credit Cards, etc.):  



Car Loans:                       



Other Loans:                     



Child Support:                   



Other Monthly payments:          

Bankruptcy?    Date:  



Foreclosure?   Date:  



Collections?   Date:  

Refinance Only?                    



Current Market Value of Property:  



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Current Interest:                  

Yes I read and state to all consumer reporting agencies and to all creditors of the undersigned please be advised that the undersigned, and each of them, has made application for PRE-QUALIFICATION with CUSTOM MORTGAGE CORPORATION requesting a potential extension of credit to the undersigned. Therefore, the undersigned, and each of them, hereby authorizes you to provide credit report and/or a disclosure to Lender or any agent or balance. The undersigned also authorizes you to disclose your credit experiences with the undersigned to Lender or related third parties.